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ED Management: the Monthly Update on Emergency Department Management

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https://www.readbyqxmd.com/read/27439227/ed-based-counseling-sessions-reduce-risky-opioid-use-among-certain-patients
#1
(no author information available yet)
Investigators at the University of Michigan have shown promising results from an ED-based intervention designed to curb risky opioid use among patients who have reported opioid misuse within the previous three months. The intervention includes a 30-minute counseling session with a therapist who utilizes motivational interviewing techniques to strengthen their desire to move away from opioid use behaviors. The randomized clinical trial included 204 emergency patients, divided between patients receiving printed educational materials and patients receiving printed materials as well as counseling sessions...
July 2016: ED Management: the Monthly Update on Emergency Department Management
https://www.readbyqxmd.com/read/27439226/fresh-approach-for-critically-ill-patients-with-time-sensitive-needs
#2
(no author information available yet)
To meet the needs of critically ill patients with time-sensitive needs, the University of Maryland Medical Center (UMMC) created the Critical Care Resuscitation Unit (CCRU), a six-bed, short-stay ICU designed to accelerate care to resource-heavy patients who require immediate evaluation and treatment. The CCRU is modeled after UMMC's trauma resuscitation unit, but with resources and staff geared toward non-trauma, critically ill patients, many of whom require life-saving care. The unit is largely staffed by emergency providers who have undergone additional training in critical care...
July 2016: ED Management: the Monthly Update on Emergency Department Management
https://www.readbyqxmd.com/read/27439225/take-a-multidisciplinary-team-based-approach-on-elder-abuse
#3
(no author information available yet)
While EDs are well positioned to identify incidents of elder abuse, providers often miss the opportunity. Experts say providers find only one in every 24 cases, and that the pendulum must swing toward over-detection. Investigators acknowledge elder abuse is difficult to confirm, given that disease processes can explain some of the signs. Further, older adults are often reluctant to report abuse because they fear they will be removed from their homes or separated from their caregivers. Given the complexity involved with addressing the issue, investigators recommend EDs establish a multidisciplinary approach to the problem...
July 2016: ED Management: the Monthly Update on Emergency Department Management
https://www.readbyqxmd.com/read/27295820/tackling-disrespectful-unprofessional-provider-behaviors
#4
(no author information available yet)
To address problematic provider behaviors that can affect patient safety, physician leaders at Vanderbilt University Medical Center (VUMC) developed the Coworker Observation Reporting System (CORS), a systematized approach for retrieving and addressing concerns about providers reported by staff. To encourage staff members to report concerns, they have to trust that the organization is going to respond, and they also have to feel that they have a certain element of psychological safety. Selected peer messengers share staff complaints with providers, enabling them to offer their perspectives on the issues or events in question...
June 2016: ED Management: the Monthly Update on Emergency Department Management
https://www.readbyqxmd.com/read/27295819/advance-care-planning-with-and-without-an-annual-wellness-visit
#5
Caral Edelberg
No abstract text is available yet for this article.
June 2016: ED Management: the Monthly Update on Emergency Department Management
https://www.readbyqxmd.com/read/27295818/new-tool-improves-processes-streamlines-operations
#6
(no author information available yet)
A one-page tool has shown promise for facilitating shared decision-making between clinicians and patients who present to the ED with low-risk chest pain. The tool, dubbed Chest Pain Choice, was developed by researchers at the Mayo Clinic. It is designed to more effectively communicate risk to patients so that they can make more informed decisions with their providers regarding treatment options. Investigators devised a study involving 898 low-risk chest pain patients in six EDs in five states. Half the patients were randomized to standard physician consultations and half received consultations facilitated by the Chest Pain Choice tool...
June 2016: ED Management: the Monthly Update on Emergency Department Management
https://www.readbyqxmd.com/read/27295817/innovative-program-targets-five-common-pain-syndromes-with-non-opioid-alternatives
#7
(no author information available yet)
To combat the prescription opioid problem, St. Joseph's Healthcare System in Paterson, NJ, has developed a new program that gives providers options they can use to effectively alleviate pain without resorting to highly addictive medication. Launched in January 2016 in the ED at St. Joseph's Regional Medical Center (SJRMC), the Alternatives to Opioids (ALTO) program utilizes protocols that primarily target five common conditions: renal colic, sciatica, headaches, musculoskeletal pain, and extremity fractures...
June 2016: ED Management: the Monthly Update on Emergency Department Management
https://www.readbyqxmd.com/read/27266001/fresh-policies-and-procedures-transparency-fuel-ed-turnaround
#8
(no author information available yet)
The ED at Banner Payson Medical Center in Payson, AZ, has charted dramatic improvements on key metrics through a range of staff and policy changes. In just a few months, the ED has halved wait times, patient satisfaction has improved, and daily volume is up. Administrators say the secret to the success of the effort is a move to be transparent by posting key metrics regarding patient flow, a tactic that has helped the team pull together and feel a sense of accomplishment when performance goals are achieved...
May 2016: ED Management: the Monthly Update on Emergency Department Management
https://www.readbyqxmd.com/read/27266000/new-opioid-prescribing-guidelines-favor-non-opioid-alternatives
#9
(no author information available yet)
Determined to make a dent in the growing problem of opioid addiction, the CDC has unveiled new guidelines for opioid prescribing for chronic pain. The recommendations urge providers to be more judicious in their prescribing, opting for opioids only after carefully weighing substantial risks and benefits. Public health authorities note the rampant use and misuse of opioids have "blurred the lines" between prescription opioids and illicit opioids. The new guidelines are designed to help frontline providers balance the need to manage their patients' chronic pain with the duty to curb dangerous prescribing practices...
May 2016: ED Management: the Monthly Update on Emergency Department Management
https://www.readbyqxmd.com/read/27265999/sounding-the-alarm-about-suicide-risk
#10
(no author information available yet)
The Joint Commission (TJC) issued a Sentinel Event Alert, noting that in too many instances healthcare providers are not recognizing signs of suicide risk in patients who present for care. While the agency calls on all frontline providers to screen for suicide risk, experts note the issue is of particular importance to EDs because this is one of the most likely places for patients at high risk for suicide to present. Beyond identifying risk, experts note emergency providers and staff must receive training to effectively manage patients at risk for suicide...
May 2016: ED Management: the Monthly Update on Emergency Department Management
https://www.readbyqxmd.com/read/27093768/vendors-provide-advice-on-emr-usability
#11
(no author information available yet)
No abstract text is available yet for this article.
April 2016: ED Management: the Monthly Update on Emergency Department Management
https://www.readbyqxmd.com/read/27093767/new-guidance-on-imaging-tests-for-a-range-of-chest-pain-scenarios
#12
(no author information available yet)
New recommendations from the American College of Cardiology and the American College of Radiology offer guidance to emergency providers on which imaging tests to use in 20 different clinical scenarios involving chest pain. For each clinical scenario, an expert panel rated the appropriateness of a range of imaging modalities as rarely appropriate (R), may be appropriate (M), or appropriate (A). The guidelines are constructed to flow from the clinician's judgment as to the probable cause of the chest pain. The recommendations for each clinical scenario are condensed into tables that can be fashioned into notecards or a smartphone app for quick reference...
April 2016: ED Management: the Monthly Update on Emergency Department Management
https://www.readbyqxmd.com/read/27093766/public-health-authorities-race-to-contain-fast-moving-zika-outbreak
#13
(no author information available yet)
With the Zika virus disease spreading rapidly through Latin America, public health authorities in the United States are racing to contain the outbreak. By the end of February, the CDC had confirmed 147 Zika cases in U.S. residents who had traveled to Zika-endemic areas. While symptoms of Zika tend to be mild, the virus has been linked to serious birth defects, so public health efforts are focused primarily at mitigating the risk Zika poses to pregnant women. By mid-February, nine pregnant women who had traveled to Zika-endemic areas and contracted the virus had been reported to the CDC...
April 2016: ED Management: the Monthly Update on Emergency Department Management
https://www.readbyqxmd.com/read/26979047/using-swarm-intelligence-to-boost-the-root-cause-analysis-process-and-enhance-patient-safety
#14
(no author information available yet)
In an effort to strengthen patient safety, leadership at the University of Kentucky HealthCare (UKHC) decided to replace its traditional approach to root cause analysis (RCA) with a process based on swarm intelligence, a concept borrowed from other industries. Under this process, when a problem or error is identified, staff quickly hold a swarm--a meeting in which all those involved in the incident or problem quickly evaluate why the issue occurred and identify potential solutions for implementation. A pillar of the swarm concept is a mandate that there be no punishments or finger-pointing during the swarms...
March 2016: ED Management: the Monthly Update on Emergency Department Management
https://www.readbyqxmd.com/read/26979046/new-policy-changes-regarding-observation-are-boon-to-emergency-medicine
#15
Caral Edelberg
No abstract text is available yet for this article.
March 2016: ED Management: the Monthly Update on Emergency Department Management
https://www.readbyqxmd.com/read/26979045/cms-proposes-prioritizing-patient-preferences-linking-patients-to-follow-up-care-in-discharge-planning-process
#16
(no author information available yet)
Hospital providers voice concerns about a proposed rule by the Centers for Medicare and Medicaid Services (CMS) that would require providers to devote more resources to discharge planning. The rule would apply to inpatients as well as emergency patients requiring comprehensive discharge plans as opposed to discharge instructions. CMS states that the rule would ensure the prioritization of patient preferences and goals in the discharge planning process, and also would prevent avoidable complications and readmissions...
March 2016: ED Management: the Monthly Update on Emergency Department Management
https://www.readbyqxmd.com/read/26979044/cleveland-hospitals-increase-capacity-hire-additional-staff-to-help-end-ambulance-diversion
#17
(no author information available yet)
With pressure from EMS to curb ambulance diversion, the four hospital systems serving metropolitan Cleveland have made a pact to bring diversion to an end. The agreement is voluntary, but all sides were determined to make the ban on diversion stick as of mid-February 2016. To get there, the health systems are increasing capacity, adding staff, and taking steps to tackle deeper hospital throughput issues. In 2015, reports noted that University Hospitals logged more than 550 hours on diversion, and MetroHealth closed its doors to new ambulance traffic for more than 400 hours...
March 2016: ED Management: the Monthly Update on Emergency Department Management
https://www.readbyqxmd.com/read/26939353/in-wake-of-terrorist-attacks-hospitals-scrutinize-protection-plans-and-procedures
#18
(no author information available yet)
No abstract text is available yet for this article.
February 2016: ED Management: the Monthly Update on Emergency Department Management
https://www.readbyqxmd.com/read/26939352/crowded-eds-leaving-proven-strategies-for-improving-patient-flow-on-the-table
#19
(no author information available yet)
While there is a plethora of proven strategies to address crowding, some of the most crowded EDs have failed to take full advantage of these tactics, according to a new study that examined the adoption of a range of both ED-based and hospital-wide interventions at hospitals between 2007 and 2010. The investigators are calling for a national strategy to address crowding as well as the implementation of new measures. They also say that more steps need to be taken so that hospital leaders are held accountable for ED crowding...
February 2016: ED Management: the Monthly Update on Emergency Department Management
https://www.readbyqxmd.com/read/26939351/as-opioid-overdose-deaths-reach-record-highs-call-for-systematic-changes-grows-louder
#20
(no author information available yet)
With deaths from opioid overdoses up sharply, a number of organizations are calling for systematic changes to curb the prescription of opioids while also making it easier for patients with addiction problems to access evidence- based treatment. New data from the National Center for Health Statistics un- derscore the scope of the problem: Deaths related to prescription overdoses reached an all-time high in 2014, nearing the 19,000 mark. Deaths linked to heroin reached 10,574, a three-fold increase from 2010...
February 2016: ED Management: the Monthly Update on Emergency Department Management
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